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J Thorac Cardiovasc Surg 2002;123:1206-1207
© 2002 The American Association for Thoracic Surgery

Brief Communications

Intrapericardial left pneumonectomy after induction chemotherapy: The risk of cardiac herniation

Alessandro Baisi, MD, Ugo Cioffi, MD, Mario Nosotti, MD, Matilde De Simone, MD, Lorenzo Rosso, MD, Luigi Santambrogio, MD Milan, Italy

From the Department of Surgery, Thoracic Unit, University of Milan, Milan, Italy.

Received for publication Oct 17, 2001. Accepted for publication Dec 10, 2001. Address for reprints: Ugo Cioffi, MD, Ospedale Maggiore Policlinico, IRCCS, Sezione Beretta Est, Via F. Sforza 35, 20122, Milano, Italy (E-mail: Ugo.Cioffi@unimi.it).


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  		Nosotti, Baisi, Santambrogio, Cioffi, Rosso, Bellaviti (left to right)

 
Acute cardiac herniation is a rare and well-described complication of intrapericardial pneumonectomy. It usually occurs within 24 hours after the operation, and it is associated with high mortality. Survival of the patient can be achieved by early diagnosis and immediate treatment.Go Go 1,2

We present a case of cardiac herniation after intrapericardial pneumonectomy in a patient who previously underwent induction chemotherapy, although the pericardial defect had been accurately closed. There are few reported cases in the literature of this exceptional complication.Go 3

Clinical summary

A 67-year-old man with a history of smoking 20 cigarettes per day for 40 years presented with a left hilar pulmonary mass. The patient underwent a chest computed tomographic (CT) scan, and a bulky clinical N2 disease was evident. Bronchoscopic examination showed that the left upper lobe was almost obstructed by a submucosal tumor. Biopsy and brush cytology results were negative. The histologic diagnosis of squamous cell carcinoma . . . [Full Text of this Article]




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